Advice and Guidance

Advice and Guidance Enhanced Service

The Advice and Guidance (A&G) process allows GPs to seek specialist input before making a formal
referral when asking about the management of a patient’s condition.

Changes to the GP contract from April 2025 offers this enhanced service to all practices with a fee
attached to it. The use of Advice and Guidance remains optional for GPs.

NHS England has published a national specification for the enhanced service and has confirmed that
this must be followed across all systems. Where a local system is requesting a process over and above
the national specification, this needs to be flagged to your LMC, or raised directly with GPC England by
emailing info.gpc@bma.org.uk

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A&G Power Point Why, What, How? PowerPoint

Dr John Patterson
Associate Medical Director NHS GM (Oldham)
SRO of GM Specialist Advice Project.

GP engagement A&G – Read-Only

Enhanced Service Specification – General Practice Requests for Advice and Guidance 2025/26

Contents
1. Introduction 3
2. Commonly Used Terms 3
3. Background 5
4. Process 5
5. General Requirements 6
6. Service Delivery Specification 7
7. Payment and Validation 8
8. General payment provisions relating to practices wishing to withdraw from the ES 10
9. Provisions relating to GP practices who merge or are formed 10
10. New contract awards 11

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